DESCRIPTION: Available data indicate two broad areas of public health
concern for Asian populations in North America: low screening participation
rates and increasing adoption of chronic disease risk factors. This
proposal focuses on cervical cancer screening and dietary behavior. The
research goal is to support the design, implementation, and evaluation of
cancer control programs targeting less acculturated ethnic Chinese women.
Specific aims are as follows: -- Collect information about cervical cancer
screening practices and barriers to, as well as facilitators of, Pap testing
participation; design culturally and linguistically appropriate
interventions to increase cervical cancer screening rates; and complete two
randomized controlled trials to evaluate the effectiveness, feasibility, and
costs of alternative Pap testing intervention approaches.
-- Develop and evaluate culturally sensitive, practical, and valid
instruments to assess dietary habits and changes in habits; and collect
information necessary for the design and delivery of nutrition education
interventions, including data on food consumption, factors affecting food
choices, and channels for nutrition information dissemination.
To increase the generalizability of findings, the research will be conducted
in two cities: Seattle, Washington and Vancouver, British Columbia.
PRECEDE will be used as an over-arching conceptual framework for the
project. During all phases of the study, community involvement will be
emphasized. In the first phase, qualitative data concerning Pap testing and
dietary practices will be collected and analyzed. This information will be
used during phases two and three: development of survey instruments,
quantitative data collection, and quantitative data analysis; and
development of audiovisual and print Pap testing education materials (for
use in the intervention programs). Finally, in phase four, we will evaluate
two cervical cancer screening interventions: one using outreach workers and
the other a direct mail approach. The same population-based samples will be
used for the quantitative surveys and Pap testing randomized trials. Nested
methodologic work addressing the validity of screening test self-report, and
both the reliability and validity of culturally appropriate dietary
assessment tools, will be completed.